Authors
Archith Rajan, Steven Brem, Daniel Gewolb, Ajay Kumar, Laiz Laura de Godoy, Arati Desai, MacLean P Nasrallah, Timothy Lucas, Laurie A Loevner, Suyash Mohan, Sanjeev Chawla
Published in
Journal of neurosurgery. Case lessons. Volume 12. Issue 16. Oct 19, 2026. Epub Oct 19, 2026.
Abstract
Neurosurgeons are in the forefront of developing clinical trials that harness the immune system to combat glioblastoma. Autologous tumor lysate-loaded dendritic cell vaccine (DCVax-L) is a novel immunotherapy for glioblastoma. An unmet need is to develop a sensitive, specific, feasible, clinically relevant, neuroimaging biomarker that accurately reflects response to immunotherapy.
This illustrative case involves a 63-year-old female who survived for 64 months following near-total resection of a glioblastoma and enrollment in a clinical trial (NCT00045968) using DCVax-L. A multivariate logistic regression model was used to assess treatment response longitudinally at 11 time points measuring predictive probability (PP) of tumor progression based on diffusion tensor imaging- and perfusion-weighted imaging-derived parameters within the contrast-enhancing region. Lesions were considered true progression (TP) if the PP was ≥ 50% and pseudoprogression (PsP; predominant treatment effects) if the PP was < 50 %. These findings were subsequently validated by histopathological analysis during resection for tumor recurrence.
These findings support the use of multiparametric MRI to monitor the effects of immunotherapy in patients with glioblastoma. Such multiparametric prediction models using noninvasive, advanced neuroimaging may be helpful to differentiate TP from PsP in longitudinal assessment of treatment response. https://thejns.org/doi/10.3171/CASE26655.
PMID:
42896233
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.
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